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General NPI Number Information
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NPI Number | 1255297016
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Entity Type | Individual
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Provider Name | FAUSTINO DE LA CRUZ JR. LMSW
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Gender | Male
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Dates
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Enumeration Date | 12/24/2025
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 1410 RICHMOND PKWY
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City | RICHMOND
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State | TX
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Zip | 77469-3617
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Country | US
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Telephone | 203-763-9143
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Fax |
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Provider Business Mailing Address
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Address Line | 5231 RIVERS EDGE DR
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City | RICHMOND
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State | TX
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Zip | 77469-2361
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Country | US
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Telephone | 203-763-9143
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 117183
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License Number State | TX
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